How this calculator works
Five routinely measured observations each contribute 0 to 3 points. The systolic pressure falls into six bands, the heart rate into six, the respiratory rate into five, the temperature into three and the AVPU level into four. A total of 5 or more was associated with increased risk of intensive care admission, cardiac arrest or death in the original validation. The score does not diagnose a cause, and a low score does not replace clinical concern. Isolated abnormal observations can be missed by a total, so read the component table as well. The result is an estimate for information only and is not medical advice.
Formula
MEWS = systolic pressure points + heart rate points + respiratory rate points + temperature points + AVPU points. Total range 0 to 14.
Worked example
A patient with systolic pressure 150 mmHg, heart rate 90 beats/min, respiratory rate 16 breaths/min, temperature 36.8 C and an alert level scores 0 + 0 + 1 + 0 + 0 = 1. Systolic pressure 210 mmHg, heart rate 135, respiratory rate 32, temperature 39.0 C and response to pain score 2 + 3 + 3 + 2 + 2 = 12.
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Frequently asked questions
Which MEWS version does this page use?
The original five-parameter score from Subbe and colleagues (2001). Later national early warning scores add oxygen saturation, supplemental oxygen and urine output, and their bands differ.
What does a score of five or more mean?
In the original validation it marked increased risk of intensive care admission, cardiac arrest or death. It is a prompt for clinical review, not a diagnosis.
Should the temperature be the highest or the current value?
Score the observation being assessed. The original table has one temperature band below 35 C and one at 38.5 C or above.
Can one high observation be ignored if the total is low?
No. A single 3-point observation is clinically important even when the total stays below five, which is why the component table is shown.